Concordancia entre citologia cervico vaginal anormal, colposcopia y biopsia de cervix de usuarias de la Clinica Colombia

El cáncer de cuello uterino, es una de las principales causas de morbimortalidad por cáncer a nivel mundial, el cual se perfila como un problema de salud pública; que gracias a la introducción de la toma de citología cervico vaginal como prueba de tamizaje, para detección temprana de cáncer de cuello uterino, ha venido en descenso. La sociedad Americana de Cáncer en estado Unidos, estima 11.270 casos nuevos para el 2009 y a nivel mundial, casi 500.000 casos nuevos (1,2). Actualmente, según las últimas estadísticas del Instituto Nacional de Cancerología 2009, comprende un 19,1% de casos nuevos. En el siguiente estudio se realizó un análisis descriptivo de concordancia, entre la citología cervico vaginal anormal, con el reporte de colposcopia y el estudio histológico (biopsia de cérvix); así como las principales alteraciones citológicas, según la clasificación de Bethesda que se presentan en las pacientes que son remitidas a la consulta de Ginecología Oncológica de la clínica Colombia. Los resultados obtenidos del estudio, nos mostró una concordancia kappa pobre a débil entre las variables: citología cervico vaginal anormal, colposcopia y biopsia de cérvix, en la Clínica Universitaria Colombia. Se recomienda realizar nuevos estudios de concordancia, previa modificación del informe de colposcopia de la CUC, para así poder unificar todos los conceptos, con el sistema de Bethesda, y el histológico y obtener un mejor resultado de concordancia.

Synthesis, Antifungal and Antitumor Activity of Novel (Z)-5-Hetarylmethylidene-1,3-thiazol-4-ones and (Z)-5-Ethylidene-1,3-thiazol-4-ones

New hetaryl- and alkylidenerhodanine derivatives 3a-d, 3e, and 4a-d were prepared from heterocyclic aldehydes 1a-d or acetaldehyde 1e. The treatment of several rhodanine derivatives 3a-d and 3e with piperidine or morpholine in THF under reflux, afforded (Z)-5-(hetarylmethylidene)-2-(piperidin-1-yl) thiazol-4(5H)-ones and 2-morpholinothiazol-4(5H)-ones 5a-d, 6a-d, and (Z)-5-ethylidene-2-morpholinothiazol-4(5H)-one (5e), respectively, in good yields. Structures of all compounds were determined by IR, 1D and 2D NMR and mass spectrometry. Several of these compounds were screened by the U.S. National Cancer Institute (NCI) to assess their antitumor activity against 60 different human tumor cell lines. Compound 3c showed high activity against HOP-92 (Non-Small Cell Lung Cancer), which was the most sensitive cell line, with GI(50) = 0.62 mu M and LC50 > 100 mu M from the in vitro assays. In vitro antifungal activity of these compounds was also determined against 10 fungal strains. Compound 3e showed activity against all fungal strains tested, but showed high activity against Saccharomyces cerevisiae (MIC 3.9 mu g/mL).

Cobertura de citología cervicouterina y factores asociados en mujeres mayores de 15 años, Kennedy, Bogotá D.C. 2005

Hace más de tres décadas existe en el mundo un programa para la prevención del cáncer de cérvix centrado en la práctica de la Citología Cervico Uterina. Aspectos como las bajas coberturas dadas por la realización de exámenes reiterados a mujeres de bajo riesgo y la no captación de mujeres de alto riesgo, pobres controles de calidad, no entrega de reportes y el bajo acceso a los servicios de diagnostico y tratamiento han impedido cambios del perfil epidemiológico de esta enfermedad en Colombia. Este estudio evalúa la cobertura, el conocimiento del reporte y los motivos para la realización o no del examen y el nivel de conocimientos con respecto a la prueba y a ésta patología.

Hematologically important mutations: X-linked chronic granulomatous disease (third update)

Chronic granulomatous disease (CGD) is an immunodeficiency disorder affecting about 1 in 250,000 individuals. The disease is caused by a lack of superoxide production by the leukocyte enzyme NADPH oxidase. Superoxide is used to kill phagocytosed micro-organisms in neutrophils, eosinophils, monocytes and macrophages. The leukocyte NADPH oxidase is composed of five subunits, of which the enzymatic component is gp91-phox, also called Nox2. This protein is encoded by the CYBB gene on the X chromosome. Mutations in this gene are found in about 70% of all CGD patients. This article lists all mutations identified in CYBB in the X-linked form of CGD. Moreover, apparently benign polymorphisms in CYBB are also given, which should facilitate the recognition of future disease-causing mutations. (C) 2010 Elsevier Inc. All rights reserved.

Statistical coupling analysis of aspartic proteinases based on crystal structures of the Trichoderma reesei enzyme and its complex with pepstatin A

The crystal structures of an aspartic proteinase from Trichoderma reesei (TrAsP) and of its complex with a competitive inhibitor, pepstatin A, were solved and refined to crystallographic R-factors of 17.9% (R(free)=21.2%) at 1.70 angstrom resolution and 15.81% (R(free) = 19.2%) at 1.85 angstrom resolution, respectively. The three-dimensional structure of TrAsP is similar to structures of other members of the pepsin-like family of aspartic proteinases. Each molecule is folded in a predominantly beta-sheet bilobal structure with the N-terminal and C-terminal domains of about the same size. Structural comparison of the native structure and the TrAsP-pepstatin complex reveals that the enzyme undergoes an induced-fit, rigid-body movement upon inhibitor binding, with the N-terminal and C-terminal lobes tightly enclosing the inhibitor. Upon recognition and binding of pepstatin A, amino acid residues of the enzyme active site form a number of short hydrogen bonds to the inhibitor that may play an important role in the mechanism of catalysis and inhibition. The structures of TrAsP were used as a template for performing statistical coupling analysis of the aspartic protease family. This approach permitted, for the first time, the identification of a network of structurally linked residues putatively mediating conformational changes relevant to the function of this family of enzymes. Statistical coupling analysis reveals coevolved continuous clusters of amino acid residues that extend from the active site into the hydrophobic cores of each of the two domains and include amino acid residues from the flap regions, highlighting the importance of these parts of the protein for its enzymatic activity. (C) 2008 Elsevier Ltd. All rights reserved.

Early Changes in Gene Expression Induced by Tobacco Smoke: Evidence for the Importance of Estrogen within Lung Tissue

Lung cancer is the leading cause of cancer deaths in the United States, surpassing breast cancer as the primary cause of cancer-related mortality in women. The goal of the present study was to identify early molecular changes in the lung induced by exposure to tobacco smoke and thus identify potential targets for chemoprevention. Female A/J mice were exposed to either tobacco smoke or HEPA-filtered air via a whole-body exposure chamber (6 h/d, 5 d/wk for 3, 8, and 20 weeks). Gene expression profiles of lung tissue from control and smoke-exposed animals were established using a 15K cDNA microarray. Cytochrome P450 1b1, a phase I enzyme involved in both the metabolism of xenobiotics and the 4-hydroxylation of 17 beta-estradiol (E(2)), was modulated to the greatest extent following smoke exposure. A panel of 10 genes were found to be differentially expressed in control and smoke-exposed lung tissues at 3, 8, and 20 weeks (P < 0.001). The interaction network of these differentially expressed genes revealed new pathways modulated by short-term smoke exposure, including estrogen metabolism. In addition, E(2) was detected within murine lung tissue by gas chromatography-coupled mass spectrometry and immunohistochemistry. Identification of the early molecular events that contribute to lung tumor formation is anticipated to lead to the development of promising targeted chemopreventive therapies. In conclusion, the presence of E2 within lung tissue when combined with the modulation of cytochrome P450 1b1 and other estrogen metabolism genes by tobacco smoke provides novel insight into a possible role for estrogens in lung cancer. Cancer Prev Res; 3(6); 707-17. (C) 2010 AACR.

A clinical decision support system for cancer diseases

The second main cause of death in Brazil is cancer, and according to statistics disclosed by National Cancer Institute from Brazil (INCA) 466,730 new cases of cancer are forecast for 2008. The analysis of tumour tissues of various types and patients' clinical data, genetic profiles, characteristics of diseases and epidemiological data may lead to more precise diagnoses, providing more effective treatments. In this work we present a clinical decision support system for cancer diseases, which manages a relational database containing information relating to the tumour tissue and their location in freezers, patients and medical forms. Furthermore, it is also discussed some problems encountered, as database integration and the adoption of a standard to describe topography and morphology. It is also discussed the dynamic report generation functionality, that shows data in table and graph format, according to the user's configuration. © ACM 2008.

A medical information system to manage a cancer database

Cancer is the second main cause of death in Brazil, and according to statistics disclosed by INCA - National Cancer Institute 466,730 new cases of the disease are forecast for 2008. The storage and analysis of tumour tissues of various types and patients' clinical data, genetic profiles, characteristics of diseases and epidemiological data may provide more precise diagnoses, providing more effective treatments with higher chances for the cure of cancer. In this paper we present a Web system with a client-server architecture, which manages a relational database containing all information relating to the tumour tissue and their location in freezers, patients, medical forms, physicians, users, and others. Furthermore, it is also discussed the software engineering used to developing the system.

Análise experimental do comportamento fluidodinâmico e da secagem de sementes de linhaça (Linum usitatissimum L.) em leito de jorro

A linhaça é a semente da planta do linho (Linum usitatissimum L.), uma espécie polimorfa originária do linho, sendo considerada uma das 6 plantas atualmente reconhecidas pelo Instituto Nacional do Câncer dos Estados Unidos (US National Cancer Institute - NCI) por suas propriedades específicas no combate ao câncer. Parte desse reconhecimento deve-se a notável característica de ser a fonte mais rica de precursores de lignina (esteróide vegetal de ação análoga ao estrógeno de mamíferos) na dieta humana. A variedade utilizada neste trabalho foi a “Linseed” de cor marrom e o objetivo deste trabalho foi analisar a fluidodinâmica dessa partícula em leito de jorro, estabelecida pelas medidas de tomadas de queda de pressão no leito a partir das deflexões em relação às velocidades de ar crescente e decrescente, obtendo assim informações para a determinação de parâmetros correlacionados ao processo, como: velocidade de mínimo jorro, queda de pressão máxima, queda de pressão no jorro estável e queda de pressão no mínimo jorro. Estes valores foram comparados aos correspondentes valores obtidos por equações empíricas citadas na literatura. Foi também avaliado o comportamento da secagem da matéria prima, mediante um planejamento estatístico 2², tendo com as variáveis de entrada temperatura do gás (T_g) e o tempo de operação (t), para a quantificação das variáveis de resposta razão de umidade (Xr, adim.), germinação (G, %) e o índice de velocidade de germinação (IVG, t^-1) e analisadas estatisticamente pelo planejamento fatorial completo com três repetições no ponto central. A cinética de secagem das sementes de linhaça, previamente umidificadas, foi realizada nas temperaturas de 45, 55 e 65 °C, e dentre os três modelos propostos, o modelo de Midilli et al., foi que melhor descreveu aos dados experimentais. Para os parâmetros fluidodinâmicos observou-se que a correlação de Gorshtein e Mukhlenov (1965) apresentou os menores desvios para queda e pressão de mínimo jorro e jorro estável, Abdelrazek (1969) apresentou o menor desvio para a velocidade no mínimo jorro e Pallai e Németh (1969) descreveu adequadamente a queda de pressão máxima. Foi observado que a carga de sementes e a temperatura exerceram influência significativa nos parâmetros fluidodinâmicos em leito de jorro. Com base na análise do planejamento estatístico proposto pode-se concluir que os parâmetros de entrada temperatura do gás e tempo de operação exerceram influência significativa sobre todas as variáveis de resposta, sendo observada influência quadrática das variáveis de entrada ao se observar a significância da curvatura sobre os parâmetros: Razão de umidade, Germinação e Índice de Velocidade de Germinação, propondo-se modelos representativos destes parâmetros com a presença da curvatura, apresentando um coeficiente de determinação (R²) superior a 99 %.

Inactivation of the putative suppressor gene DOK1 by promoter hypermethylation in primary human cancers

The DOK1 gene is a putative tumour suppressor gene located on the human chromosome 2p13 which is frequently rearranged in leukaemia and other human tumours. We previously reported that the DOK1 gene can be mutated and its expression down-regulated in human malignancies. However, the mechanism underlying DOK1 silencing remains largely unknown. We show here that unscheduled silencing of DOK1 expression through aberrant hypermethylation is a frequent event in a variety of human malignancies. DOK1 was found to be silenced in nine head and neck cancer (HNC) cell lines studied and DOK1 CpG hypermethylation correlated with loss of gene expression in these cells. DOK1 expression could be restored via demethylating treatment using 5-aza-2'deoxycytidine. In addition, transduction of cancer cell lines with DOK1 impaired their proliferation, consistent with the critical role of epigenetic silencing of DOK1 in the development and maintenance of malignant cells. We further observed that DOK1 hypermethylation occurs frequently in a variety of primary human neoplasm including solid tumours (93% in HNC, 81% in lung cancer) and haematopoietic malignancy (64% in Burkitt's lymphoma). Control blood samples and exfoliated mouth epithelial cells from healthy individuals showed a low level of DOK1 methylation, suggesting that DOK1 hypermethylation is a tumour specific event. Finally, an inverse correlation was observed between the level of DOK1 gene methylation and its expression in tumour and adjacent non tumour tissues. Thus, hypermethylation of DOK1 is a potentially critical event in human carcinogenesis, and may be a potential cancer biomarker and an attractive target for epigenetic-based therapy.

Using Prior Information from the Medical Literature in GWAS of Oral Cancer Identifies Novel Susceptibility Variant on Chromosome 4-the AdAPT Method

Background: Genome-wide association studies (GWAS) require large sample sizes to obtain adequate statistical power, but it may be possible to increase the power by incorporating complementary data. In this study we investigated the feasibility of automatically retrieving information from the medical literature and leveraging this information in GWAS. Methods: We developed a method that searches through PubMed abstracts for pre-assigned keywords and key concepts, and uses this information to assign prior probabilities of association for each single nucleotide polymorphism (SNP) with the phenotype of interest - the Adjusting Association Priors with Text (AdAPT) method. Association results from a GWAS can subsequently be ranked in the context of these priors using the Bayes False Discovery Probability (BFDP) framework. We initially tested AdAPT by comparing rankings of known susceptibility alleles in a previous lung cancer GWAS, and subsequently applied it in a two-phase GWAS of oral cancer. Results: Known lung cancer susceptibility SNPs were consistently ranked higher by AdAPT BFDPs than by p-values. In the oral cancer GWAS, we sought to replicate the top five SNPs as ranked by AdAPT BFDPs, of which rs991316, located in the ADH gene region of 4q23, displayed a statistically significant association with oral cancer risk in the replication phase (per-rare-allele log additive p-value [p(trend)] = 2.5 x 10(-3)). The combined OR for having one additional rare allele was 0.83 (95% CI: 0.76-0.90), and this association was independent of previously identified susceptibility SNPs that are associated with overall UADT cancer in this gene region. We also investigated if rs991316 was associated with other cancers of the upper aerodigestive tract (UADT), but no additional association signal was found. Conclusion: This study highlights the potential utility of systematically incorporating prior knowledge from the medical literature in genome-wide analyses using the AdAPT methodology. AdAPT is available online (url: http://services.gate.ac.uk/lld/gwas/service/config).

Cooperative effects of aminopeptidase N (CD13) expressed by nonmalignant and cancer cells within the tumor microenvironment

Processes that promote cancer progression such as angiogenesis require a functional interplay between malignant and nonmalignant cells in the tumor microenvironment. The metalloprotease aminopeptidase N (APN; CD13) is often overexpressed in tumor cells and has been implicated in angiogenesis and cancer progression. Our previous studies of APN-null mice revealed impaired neoangiogenesis in model systems without cancer cells and suggested the hypothesis that APN expressed by nonmalignant cells might promote tumor growth. We tested this hypothesis by comparing the effects of APN deficiency in allografted malignant (tumor) and nonmalignant (host) cells on tumor growth and metastasis in APN-null mice. In two independent tumor graft models, APN activity in both the tumors and the host cells cooperate to promote tumor vascularization and growth. Loss of APN expression by the host and/or the malignant cells also impaired lung metastasis in experimental mouse models. Thus, cooperation in APN expression by both cancer cells and nonmalignant stromal cells within the tumor microenvironment promotes angiogenesis, tumor growth, and metastasis.

Strategies and results of the oral cancer prevention campaign among the elderly in Sao Paulo, Brazil, 2001 to 2009

Objective. To describe the strategies and results obtained by the early diagnosis and prevention of an oral cancer campaign targeting the population aged 60 years or older developed since 2001 in the state of Sao Paulo. Methods. The main strategies used to develop the campaign were described based on the review of documents issued by the Health Ministry, National Cancer Institute, Sao Paulo State Health Department, Oncocentro Foundation of Sao Paulo, Sao Paulo City Health Department, School of Public Health at the University of Sao Paulo (USP), and Santa Marcelina Health Care Center. The impact of the campaign on the incidence of new cases of oral cancer in the target population was evaluated. Results. In 2001, 90 886 elderly were examined vs. 629 613 in 2009. The following strategies were identified: training of professionals, development of printed materials to guide municipal governments in developing the campaign and using standardized codes and criteria, guidelines for data consolidation, establishment of patient referral flows, practical training with a specialist at the basic health care unit after the follow-up examination of individuals presenting changes in soft tissues, and increase in the number of oral diagnosis services. Between 2005 and 2009, there was a significant reduction in the rate of confirmed cases of oral cancer per 100 000 individuals examined, from 20.89 to 11.12 (P = 0.00003). Conclusions. The campaign was beneficial to the oral health of the elderly and could be extended to include other age groups and regions of the country. It may also provide a basis for the development of oral cancer prevention actions in other countries, as long as local characteristics are taken into account.

Effect of acute and chronic GVHD on relapse and survival after reduced-intensity conditioning allogeneic transplantation for myeloma

We evaluated the effect of acute and chronic GVHD on relapse and survival after allogeneic hematopoietic SCT (HSCT) for multiple myeloma using non-myeloablative conditioning (NMA) and reduced-intensity conditioning (RIC). The outcomes of 177 HLA-identical sibling HSCT recipients between 1997 and 2005, following NMA (n = 98) or RIC (n = 79) were analyzed. In 105 patients, autografting was followed by planned NMA/RIC allogeneic transplantation. The impact of GVHD was assessed as a time-dependent covariate using Cox models. The incidence of acute GVHD (aGVHD; grades I-IV) was 42% (95% confidence interval (CI), 35-49%) and of chronic GVHD (cGVHD) at 5 years was 59% (95% CI, 49-69%), with 70% developing extensive cGVHD. In multivariate analysis, aGVHD (>= grade I) was associated with an increased risk of TRM (relative risk (RR) = 2.42, P = 0.016), whereas limited cGVHD significantly decreased the risk of myeloma relapse (RR = 0.35, P = 0.035) and was associated with superior EFS (RR = 0.40, P = 0.027). aGVHD had a detrimental effect on survival, especially in those receiving autologous followed by allogeneic HSCT (RR = 3.52, P = 0.001). The reduction in relapse risk associated with cGVHD is consistent with a beneficial graft-vs-myeloma effect, but this did not translate into a survival advantage. Bone Marrow Transplantation (2012) 47, 831-837; doi:10.1038/bmt.2011.192; published online 26 September 2011

Etablierung und Anwendung von biophysikalischen und molekularbiologischen Methoden zur Untersuchung von Wirkmechanismen neuer Indol-, Carbazol- und Oligopyrrolcarboxamid-Derivate als potentielle antitumoraktive Stoffe

Im Rahmen der gezielten Suche nach neuen Leitstrukturen mit antitumoraler Wirkung werden im Arbeitskreis U. Pindur seit Jahren verschiedene Strukturvarianten der Indol-, Carbazol und Pyrrol-Reihe studiert. Durch die Vielzahl neu synthetisierter Verbindungen war es erforderlich, geeignete Screening-Verfahren für die Routineanalyse zu etablieren, die möglichst früh vielversprechende Substanzen detektieren können.Zwei bedeutsame Targets der antitumoralen Wirkstoffe sind die DNA und die Topoisomerase I. Demzufolge war es das Kernziel dieser Arbeit, in erster Linie Assay-Verfahren zu studieren und neu zu etablieren, die eine Wechselwirkung von neu-synthetisierten Verbindungen mit diesen Targets nachweisen könnten.Im Rahmen dieser Arbeit wurden vier Assay-Verfahren neu etabliert und für die Routineanwendung optimiert: die Bestimmung der DNA-Schmelztemperatur, der Ethidiumbromid-Verdrängungsassay, der Unwinding-Assay und die Bestimmung der Topoisomerase I-Hemmung.Mit diesen vier Methoden, die mit Hilfe neuer Synthesesubstanzen und bekannter Standard-Cytostatika in dieser Arbeit aufgebaut, validiert und optimiert wurden, und mit den Ergebnissen der Zytotoxizitätsbestimmung, die im National Cancer Institute durchgeführt wurde, sollten nun erste Basisinformationen zum zukünftigen Aufbau von Struktur-Wirkungsbeziehungen der im Arbeitskreis U. Pindur synthetisierten Verbindungen geliefert werden.Aus der Analyse der Problematik bei der Durchführung der Assays zur Bestimmung der Wechselwirkungen mit der DNA und der damit ermittelten Ergebnisse hat sich eine Reduktion der Lipophilie der Testverbindungen als besonders wichtig herausgestellt, denn die meisten Assays werden in wäßrigem Puffer durchgeführt.In Hinblick auf Struktur-Wirkungsbeziehungen der neu synthetisierten Verbindungen konnten ausgehend von den bisherigen Ergebnissen erste vororientierende Korrelationen zwischen den verschiedenen Assay-Daten aufgestellt werden. Allerdings konnte auf Grund der Heterogenität der rationalen Hintergründe der Testverfahren und der Heterogenität der untersuchten Stoffgruppen noch kein einheitliches weiterführendes Strukturkonzept erarbeitet werden. Lediglich bei den Pyrrolcarboxamid-Derivaten konnte unter Berücksichtigung folgender Informationen eine weitergehende Strukturoptimierung vorgenommen werden. Eine terminale Dimethylaminopropyl-Gruppe sowie mindestens zwei Pyrroleinheiten bzw. drei amidische Gruppen bei den DNA-rinnenbindenden Pyrrolcarboxamid-Ketten sind erforderlich, um eine Wechselwirkung mit der DNA zu erreichen. Der interkalierende Teil der als potentielle „Combilexine“ entwickelten Oligopyrrolcarboxamid-Derivate sollte eine große Affinität zur DNA aufweisen, sonst scheint dieser Strukturabschnitt eher einen sterischen Störeffekt bei der Bindung in die Rinnen der Seitenkette hervorzurufen.Eine Analyse der erforderlichen strukturellen Eigenschaften für die Wechselwirkung mit der Topoisomerase I war nicht möglich, denn Testverbindungen unterschiedlichster Struktur haben eine Hemmung dieses Enzyms gezeigt. Weiterhin ist keine Korrelation zwischen der DNA-Affinität und der Fähigkeit zur Hemmung der Topo I festzustellen. Dennoch konnte die zytotoxische Wirkung bei einer Vielzahl von Verbindungen mit einer Hemmung der Topoisomerase I erklärt.Auf Grund der vorliegenden Ergebnisse sollten nun weitere Verbindungen gezielter synthetisiert werden, deren Analyse mit Hilfe der im Rahmen dieser Arbeit etablierten Verfahren zur Aufklärung weiterer essentieller Punkte für die Wechselwirkung mit der DNA und den Topoisomerasen führen soll.